Organization
WESTERN LEGACY PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE NICOLE FAIRBANK PT, DPT (PHYSICAL THERAPIST, OWNER)
(620) 855-6060
Entity
Organization
Contact information
Practice address
700 WEST AVENUE A, CIMARRON, KS 67835
(620) 855-6060
Mailing address
PO BOX 389, CIMARRON, KS 67835-0389
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/02/2025
Last updated
07/24/2025
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